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Avatar universal

Antidepressants- Antidepressants - Antidepressants -Wellbutrin and Others

Antidepressants. Talked to my therapist about them today. I'm not  depressed in the sense that I'm "depressed" but feeling mentally sluggish, hard to get out there and get going. Little motivation. Besides going to the gym, not being very productive. Been down so long with tx, thought I may need a little "jump start" in the form of an AD to get back up.

Hopefully your collective experience will give me some insight. I never took antidepressants (AD's) so this is all very new to me.

Therapist recommended Wellbutrin. This is an SSNI as opposed to the slightly newer SSRI's but he still likes it. Therapist thought Wellbutrin was the more "energizing" of the different alternatives.

Anyone try Wellbutrin (active ingredient bupropion)? He also mentioned Efflexor as another option.

The ADs I'm familiar with are the SSRI's like Prosac, Zoloft, Lexipro, etc. They seem to be more popular here.want. Therapist is very open in terms of what I can take.

Has anyone tried both SSRI's and SSNI's like Wellbutrin? What is the difference?

Any info is appreciated regarding any ADs you may be familiar with. What to expect? How long they take to kick in? Any side effects? Were they energizing or the opposite? Did they help motivate and give you focus? Did you take them during treatment or when not treating,as I imagine there may be a diffence.  Currently, I'm 19 weeks post treatment.

-- Jim  

33 Responses
148532 tn?1216644162
I have been taking ADs for about 15 yrs for fibromyalgia and for the last 6 have been taking the wellbutrin. The reason I stay with it is that the side effects varing from diarrhea to weight gain werent there with wellbutrin. Prozac was bad for me life didnt get me down anymore but nothing lifted me up either and I'm usually easily inspired by everything from sunshine to a new flower. Wellbutrin has not dulled my zest for life and I sleep well with it. Hope this info doesnt go against others ideas and hope it helps you decide.
Avatar universal
Hello Jim,
I agree that Wellbutrin may be one of the more "energizing" of the AD's. I am a psychiatric social worker and have seen hundreds of clients (and some friends and family) take ADs. A number of them report that Wellbutrin makes them "edgy", "anxious" and even "panicky". Please be aware of these potential side effects if you go that route. Effexor seems to be really effective but can have the same agitating side effects but from what I've heard, generally less so. Lexapro seems to be one of the more "benign" ADs, combining effectiveness with minimal side effects. Bottom line for me though is that I agree with much of what Rocker says in the above post, stay away from these drugs if at all possible and use them only for moderate to severe depression, as opposed to mild and transient depression. Again, I am NOT a doctor but I do work side by side with one who treats depression. Sounds like you are working with a good therapist too. Maybe consider a triple extra tall latte on those "dog days"? Hope you find a solution!    - Lee
100019 tn?1335923317
Early on in my tx I spoke with three people that were taking the SSRI's during therapy.  They all finished tx within a couple weeks of each other and ALL of them over the next couple months experienced terrible sides during the weaning process.

That was the main reason I never started on them.  During tx I've been depressed and at times suicidal, but the thought of what they went thru trying to get off of them was enough to scare me to.

As always this is only my experience and I do know that many people react differently.

If I had to go on something I would stay away from the SSRI's.

Just my two cents.  Good Luck, Valorie
Avatar universal
Never took one in my life before tx but now I simply find Paxill to have helped me GREATLY.  I truly believe that I ALWAYS needed it just to cool out my brain.

I will try and detox from them SLOWLY eventually and see if there is a difference and I want to go back on or not but for now...lifesaver to me.

Avatar universal
well here i do have some experience..i have been on prozac, wellbutrin,effexor,zoloft etc.  what you need to know is are you depressed as a side effect of tx or did tx activate a previous condition?..they use wellbutrin alot of times as a conjuctive with the ssri's helps to kick them in gear. lexapro and effexor are pretty good at low dose in conjuction with wellbutrin..i know from previous when i first started tx that i was being treated for depression to find out that i was bipolar and the anti's make this worse..i suggest talking with your shrink and make sure ..my bipolar was triggered by tx as i had post partum back in the 80's..and fyi its really hard when you come off of the anti's..so be careful during tx. these guys in here helped when i first started tx with all the mental sides. now stable thanks to all just having the other sides which just plain stink..oh well still hanging in there and keeping positive..to all have a great weekend...heres to injection 20..shelly:)
Avatar universal
I got it backwards when I read your post.  The Paxill DOES chill me out (I think?) God knows with all the Riba, RibaRage and severe anemia I guess honestly it would be hard to tell WHAT is up with what if you know what I mean?
Avatar universal
Got it. In my case I don't want to be "chilled out" but heated a bit :) On the other hand, from my limited knowledge of these drugs they can often have multiple effects -- in other words, while the drug may chill one person out, they may also give another more energy, or so I think. More to discuss with the shrink.
Avatar universal
Honestly it's hard to nkow what ANY specific medication is doing any more because we're (I'm) on so many of them.  Honestly since I take it every NIGHT with my Ambien CR but I don't really sleep well maybe it IS  keeping me up and I don't know it?

You know?  It's just gotten to the point where it's impossible to tell unless one more is added at a time (but I started all these at the same time or so).

I think talking to a shrink would be best - they should know how people react to one compared to another without any riba or ambien or anything affecting the way it's PERCEIVED to be acting.

You know what I am trying to say?
Avatar universal
Dr. J day is ten days away........I wont mind doing 72 if it will really help me improve the odds that much you know?  I don't EVER want to do this again if I can help it. Not even if they come out with a painfree/sidefree drug - I'd rather try and get rid of it now.

I can't wait to see what he says but I still need to come up with the CASH to pay him.  Hoping my parents will lend it until I can submit to insurance. $600 for a new patient visit. WOW. I just dont have extra cash like that laying around...no way!

(I have such a list for Dr. J he's gonna throw me OUT I have so many questions to throw at him lol)
Avatar universal
Thanks for the comments.

Ohio...This jives with what my doctor said. The "jittery part does give me concern for a number of reasons including my profession which is writing. Never could write/think well with any stimulant including too much caffeine. Something I will def discuss with my doc. Glad Wellbutrin is working for you.

Strange...The Wellbutrin/Lexipro cocktail sounds enticing. A lot for me to learn here.

NY...Glad Paxil is smoothing out the edges of treatment. However, now that the riba has about said sayornora to me, I need something to get me going not calm me down, but maybe I misread your take on Paxil.

Rocker...Thanks for your thoughts and links on the subject. I do understand somewhat the underbelly of ADs but like with tx, right now I'm weighing the risks versus the rewards and think it is worth the try at least for the short term. I've never been in any way suicidal and while aware of some of the stats, this doesn't concern me. BTW check out: http://tinyurl.com/
It turns long url's (web addresses) into short ones. For example, the first url you posted would be automatically condensed to:
http://tinyurl.com/lp3hb  Not only does it save space, but it won't expand the thread liness (notice how wide this thread has gotten) which make things harder to read, at least on a notebook monitor.
Avatar universal
I hear you. When I was on treatment didn't know what was causing what, just so much going on. My shrink is quite knowlegeable about the pharmokenetics (sp?) of these drugs but it's always useful to get the "field" experience for such a diverse group as this. I'm definitely somewhat filtering comments from those that have taken ADs solely on treatment from those who have taken ADs off of treatment, although I'm interested in all coments.

Hope sides are treating you as well as can be expected and all the best luck with DR. J. I know you expect him to say 72 weeks but I wouldn't be surprised if he lets you off the hook with 60. Just a wild guess but he and Dr. D. are "the man" in the NY area, so you will be well served whatever he advises. BTW you might mention you fudgicle addition to him and ask if it's a permanent side or not :)

-- Jim
Avatar universal
It's worth the cash to get pointed in the right direction. If you think you might want to treat with him, you can always ask if he will accept an assignment from your insurance company. Sometimes they do that after the first visit.

A little advice I learned the hard way. A list of questions is great, but at times in the past I so peppered the doctor with questions that I lost out on a real opportunity to get all of his thoughts which may have gone beyond my concerns. And with someone like Dr. J. you really want to hear what HE has to say first without rushing his thoughts to get in your questions.

Regarding the questions, definitely prioritize the list and weed out the stuff maybe his NP could answer, as you'll probably meet with both.

All the best with your consult.

-- Jim
Avatar universal
Yeah, sure could use more "smiles". LOL. Sounds like you're taking Wellbutrin and not Wellbutrin XL which I believe is a newer formulation. Wellbutrin XL is once a day dosing while reg Wellbutrin I think is 2X a day. I guess you don't know how these things will hit you until you take them. How long was it before you felt the effects after you started. Thanks.

-- Jim
Avatar universal
I started taking ad's about a year prior to treatment.  It had nothing to due with the Hep C rather several personal crises that all happened within a few months.

Zoloft made me tired and seemed to do nothing at all.  My dr. then put me on Paxil which helped me maintain my emotions and function at first.  After a few months on the Paxil I lost all energy and just wanted to cry.  Again, this was prior to tx.

Just before I started tx I was put on Effexor.  I believe it helped me considerably thru some of the real rough days in tx.  I'm still taking it and don't know that I ever want to stop.  I am much more rational emotionally and feel like I have more energy.

Just me experience.  Hope it helps with your decision.
Avatar universal
I think I noticed within a week or two.  Sort of a gradual Wow, I feel better! I was still pretty fatigued from the HCV but had a much better attitude about everything.  I laughed with the kids a lot more, even had a higher libido!  That's another side effect I hear.

Yes, mine is the SR.  I don't feel the need to update to the new one.  Initially I could tell when I would forget to take it but now, especially with all these drugs, I take it for a few weeks when I feel the need.  Hoping not to need it at all soon.  

Good luck with your choice and I sure hope it helps you.

miss
Avatar universal
i used wellbutrin for awhile & i did indeed gain a double expresso effect-i did not mind at all as depression can be physically tiring...i used v low dose & it worked well for me....Lexapro can mess w/ libido-Now that's depressing!!...Xanax might fit your bill-take when needed only;gives ya an energy boost and will help you to see the beauty that is life...i never used AD's before trx,but if you need them,don't hesitate-GOOD LUCK,hey what about an "illegal smile;it don't cost very much,but lasts along while.."??
Avatar universal
Thanks for sharing your experience. Yeah, a double-expresso would be nice about now :) Do you remember your dose? I thought Wellbutrin only came in one dose that was taken 2X a day with the newer XL formulation dosed once a day. Are you sure you're talking about Xanax for energy? I thought it was a sedative?
116701 tn?1210262764
My doctor forced me into Welbutron (?) and I went in with a negative attitude. Results were no sleep (nice side while on riba) and made me very snappy (wife will attest to this). I stopped taking them and I felt better. I haven't taken any of them since week 7 or 8 and had to start them one month prior to treatment beginning. My doctor did tell me one day that if you aren't experiencing a chemical imbalance that taking these uptake drugs can have some weird sides. I really just wanted you to know about the sleep problem I had though. Dale
Avatar universal
I feel for you.   I think sometimes children are affected so much more with drugs than adults. My son was diagnosed ADD and they had him on the standard ritalin.  He told us after a year or so that it made him feel strange.   After about 4 years down the road,  we pulled him off it one summer and he went nuts.  Had us really  worried and scared.  Once we completly weened him off it we decided I can stand they hyperness more than the extreme moods that the ritalin put him in.  To this day he  has never gone back on it and has worked to deal with his hyperness himself.  Actually I think he has grown out of some of it on his own.  Anyway I understand and hope all works out okay for him and your family.
Avatar universal
Just so happens I have a 15 yr old son who particpated in an anti-psycotic drug study last winter because of the very topic for which you posted the article link for as more research is being done to determine why teens on AD's have a higher rate of suicide.

He was initially diagnosed as being depressed and put on AD's.  After being on AD's he expressed having more suicidal thoughts, which landed him a weeks stay in the adolescent observation ward at the University of Minnesota.  But as a result of that visit, he also was selected to participate in the study in which he was given Seroquel, which fortuantely also looked like the most promising drug in the study.

Bottom line is that the study found many teens are being mis-diagnosed with depression when they may actually be suffering from varying forms of schizophrenia or psychosis.  Also, that giving person suffering from either of these AD's results in them being more violent with suicidal tendencies.

Sorry I do not have a link for the study he was involved in at my finger tips, but for those interested, this one explains the issue a bit more:

http://www.schizophrenia.com/sznews/archives/003697.html
Avatar universal
Hello Jim,

I'll just add my experience with AD's-Wellbutrin.

About ten years ago I saw a doc for an unrelated thing and the first thing he wanted to talk about was my depression.  I had been depressed for a lot of years (I suspect because of HCV) but without ins or $, treating it was not an option.  I took extra B, etc but to no avail.  I was truly suffering from depression.  

He tried me on something, maybe Paxil, don't remember, but it didn't work.  Then Wellbutrin, and it was night and day.  My script is for two a day but I generally only take one in the morning. Taken too late at night does keep you up.  Then I get two months for the price of one!  lol

At first it was "energizing" in that it really took the depression away.  After all these years I don't take it regularly, only during certain spells of depression.  They say it must build to a certain level in your blood.  Another strange thing is I still couldn't quit smoking while on it but it is often rx'd for that.

A friend tried it and couldn't quit smiling, even on a low dose.  We're all different but if it works, then it works.  I hate taking it but hate feeling bad too.  

Good luck with your decision, it can't be easy for you.  

miss
Avatar universal
I have always battled extremely low energy and depression (hepc?) Before treatment I used DHEA for about a year and really found it effective. It is not legal in Canada as FDA still has not approved it. (I get it from the states). I tried Effexor when I started treatment but HATED it and switched to Prozac which I dont notice any altered feelings, just a little energy and not having to think about standing up for 10 min before doing it. My doc also tried me on seroquel at night to deal with insomnia and help with anxiety. I couldn't sleep, it gave me "restless leg syndrome" which is crazy-making. Now I use prozac in am and remeron in pm to help with sleep. It's a good combo, Prozac is a SSRI and remeron actually supplies more seratonin for the Prozac to use. And both doses are low so it should be easier to stop them when its time. I never took DHEA while on treatment but I'm starting to again and cut back the prozac. Sorry I never have links like you guys but google it in relation to antidepressant use, there is some good info and it really does help with energy.Hard to believe I'm not only talking about these drugs with first hand knowledge but am taking them. Used to be such a wienie about anything altering or stabalizing. Saw it as a reflexion of me.
Avatar universal
Antidepressants.... they can be a good thing.  Sometimes one does not know they are depressed.  I didn't..just knew I had a hard time wanting to do anything (even those things that I and everyone knew I loved to do).  Also I found I was sleeping less and less.  When it got to where I was sleeping 20 hours a week I finially went to the doctor.  He put me on  Citalopram which is a generic for something not sure.  Anyway, I was on it for six months and then pulled myself off.  I tell you I feel like a new person.  Maybe they could perscribe something on the mild side that would do the trick.  Its worth a try for six months and see if it lands you in a different place.  I think alot of people (me included originally) think you have to be loony to take them but I found out that no you don't.
Avatar universal
I do hope your son is ok from this study,
my son was misdiagnosed when young & resulted in
long term affects to this day and he is 23.
One drug they think (forget the name)
but I know it started with an "R", the drs.
think he became diabetic due to being on that
drug for just a short period of time.

It's hard to live with being misdiagnosed
but the family history is so strong that the
drs I think, were doing there best, at least
that's what I say so I can live with the results
of his ealier prescribed drugs.

He takes wellburtrin now, (and actually many other drugs
along with his insulin (two types-humolog & lantus)
the wellburtrin he says does help him, but I
don't think he would need it, if he was properly diagnosed
when first symptons appeared, and I don't think its a drug
for just random giving out, the big deal about this drug
is somehow they linked it to assisting people with quiting smoking, my son uses it as an aid for concentration, and then other drugs for seizures, which are not controllable & affects concentration, long term and short term memory..
anyway enough of my son's story

I just hope your son is ok.
Avatar universal
Hi Jim-
Years before treatment I was on Zoloft after beginning my road
to recovery from drug addiction. At the time I was not ready
to deal with myself through therapy so they put me on Zoloft,
after 3 weeks when nothing happened, they increased my dose. I was on it for quite a few months, though personally I don't think it did much good. It did sort of chill me out, but that really wasn't too much help, and like you said earlier, this could be different w/ different people.

Anyway, I went through a few months of therapy last year and it helped much more--not that the therapist was any help (I stopped seeing her after she fell asleep while I was talking) but the talking through things did. 4 years ago when I began my "successful" recovery I found that going back to school which forced me to engage w/ others was the best help out of anything. I still get depressed in the summer, right about this time, when my summer class is over and fall semester hasn't begun. Anyway, hope this helps, I don't know, it's a bit rambling...wow
Avatar universal
Thanks for your concern and sorry to hear about your son.  Nick seems to be doing better than he was last fall, but docs still aren't sure how to help him and simply try to follow protocols.

It seems these days that either the diagnostic skills of our medical people fall far short of those in years gone by or the insurances are hamstring them to the point that they are unable to use the proper diagnostic tools at their disposal unless the patient is rich or important enough to justify it.

I suppose that's why they call it "practicing medicine",  you'd think that sooner or later they'd quite practicing and do it for real.  Nowdays it seems like it's simply throw this or that drug at them to see what happens and if it falls short try some other drug.
Avatar universal
i can't rem dosage of wellbutrin-probably was just the standard,but my doc always cautious..the xanax does stimulate in a v mild&friendly way-maybe just me? but i use it v sparingly ,at most 4 times aweek..it is fast acting and can save the day and reduce stress..i won't take it in the evening cause insomnia  ensues..that's a problem that needs no encouragemnt ...Heck you have alot of options & i'm sure you will solve this ...Before trx i used samE as  livertonic-but it also improved my mood & energy,esp when taken w/ good cupa strong java....that might help?
Avatar universal
i can't rem dosage of wellbutrin-probably was just the standard,but my doc always cautious..the xanax does stimulate in a v mild&friendly way-maybe just me? but i use it v sparingly ,at most 4 times aweek..it is fast acting and can save the day and reduce stress..i won't take it in the evening cause insomnia  ensues..that's a problem that needs no encouragemnt ...Heck you have alot of options & i'm sure you will solve this ...Before trx i used samE as  livertonic-but it also improved my mood & energy,esp when taken w/ good cupa strong java....that might help?
Avatar universal
one more matter to consider in regards to some AD's-they can enlarge prostate and reduce "the flow"...i understand this may be a concern for you-Do we know TOO much about forum members? (-:
Avatar universal
Thanks man for reminding me! That used to the first thing I'd check out with any drug during treatment. Because of the "flow" I stayed away from any decongestants and some other stuff can't seem to remember. Even took Flomax for a while although not crazy about its side effects. Anyway, the "flow" has been much better lately and the last thing I want is more problems. Hopefully Wellbutrin won't affect it. I'll definitely ask my doc and will do some research now. I forgot -- do you have any prostate issues and are you on any meds such as Flomax or Proscar? Actually I was supposed to start Proscar a few months ago but like I said, things have been getting better and I'm kinda a watch and wait guy anyway :)

-- Jim
Avatar universal
Hi, I found one of the links for dhea. Its worked well for me, but any more than 25mg. at once will make me feel speedy. I can use 2 doses am and pm if I'm going to some function but I really dont know what I'll use or need if I've cleared this virus. Good chance this is too buried for you to ever see, let me know if you do, OK...........Diane

Oh yeah, the link (still needing some brain repairs)
http://www.life-enhancement.com/article_template.asp?ID=264
Avatar universal
Just wanted to thank everyone for their experiences and insights. This kind of input is very helpful.

-- Jim
1618921 tn?1298826421
I am currently on 20mg of paxil, and my therapist is now trying to wein me from...
20mg of paxil with 10mg of celexa first week
10mg of paxil with 20mg of celexa second week
20mg of celexa alone the third week with no paxil.
Has anyone else done this? I am very nervous an need support, I have been on paxil for about 8 years an it seems to be taking a toll on my body now that im not liking. I feel so lost an alone...
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